Stage 4: Advanced gout (chronic tophaceous gout) This is a stage of chronic gouty arthritis, in which there are lumps of uric acid, or tophi (see Figure 2: Illustration of Toe Joint With Gouty Tophus ), frequent attacks of acute gout, and often a degree of pain even between attacks (see Figure 3: Progression of Gout )
Ethics statement The studies involving human participants were reviewed and approved by the local ethics committee in Stockholm (2016/1485-32, amendment 2017/779-32)
J Trace Elem Med Biol 32:3039 Rasmussen LB, Schomburg L, Khrle J, Pedersen IB, Hollenbach B, Hg A, Ovesen L, Perrild H, Laurberg P (2011) Selenium status, thyroid volume, and multiple nodule formation in an area with mild iodine deficiency
It shuttles electrons between metabolic reactions to fuel cellular energy production